News in brief: Perils of aspirin in primary prevention; Fizzy tablets need heart warnings; Males in denial about gender-biased peer review

Perils evident for aspirin in primary prevention

Clinicians should reassess the risk–benefit balance of aspirin for the primary prevention of cardiovascular events, especially in older patients.

A retrospective study of 296 patients admitted with GI bleeding to one of three tertiary hospitals in Adelaide during a six month period in 2017, identified 22 who were using aspirin for primary prevention of cardiovascular disease.

The patients, with a mean age of 76 years, had a mean hospital stay of 3.5 days at a cost of $6,769 per admission.

They represented 7.4% of all hospitalisations for drug-related GI bleeding.

“There remains a notion in clinical practice that a tiny dose of aspirin can be safely added as a ‘just-in-case’, with a possible benefit and no downside of associated harm. Our ageing population, along with the associated increase in vulnerability to any blood-thinning agents associated with ageing physiology, has exposed this as fallacy,” the study said.

“Recent guidelines indicate there is little or no place for primary prevention aspirin use in patients aged>70 years due to this increased bleeding risk.”

Read more in the Internal Medicine Journal.

Fizzy tablets need heart warnings

Effervescent medications contain massive doses of hidden salt and should come with stronger warnings about their cardiovascular risks, according to Australian researchers.

Soluble formulations of paracetamol contain up to 440 mg of sodium per tablet, meaning that an individual would consume well in excess of the maximum daily dose of 2000mg sodium chloride if taking a full dose paracetamol regimen, according to Professor Aletta Schutte and Bruce Neal of the George Institute for Global Health, Sydney.

They said blood pressure rises from the high salt content might explain a 60% higher risk of cardiovascular disease and death seen in regular users of soluble paracetamol compared to other types of paracetamol.

Higher cardiovascular risks could also be expected for other types of effervescent medications such as antacids, vitamins and urinary alkalinisers, they wrote in the European Heart Journal.

“There is an immediate need for protection of consumers against these risks. The most plausible and effective strategy is likely to be the mandatory labelling of all medications containing significant quantities of sodium with a front-of-pack warning label,” they suggested.

Males in denial about gender-biased peer review

Gender disparities will continue in medical and scientific research funding so long as male medical researchers remain in denial about systemic bias in areas such as peer review, an immunologist says.

Dr Jessica Borger says there is clear evidence that of gender bias against women in funding application processes such as the NHMRC,  and the problem increases with seniority.

Writing in Women’s Agenda she notes that funding rates for women in the the recent 2021 Investigator Grants outcomes were 2–4% lower than those for men, enough to results in noticeable disparities in funding rates.

The bias is inherent in peer review system and needs to be tackled with gender quotas, she says.

“With more men than women receiving funding in the top bracket, women on average received $500,000 less per grant than the men despite being at the same level of seniority. Ultimately, this means of the few successful senior women retained to do competitive research, are doing so with significantly reduced funds compared to their male counterparts, limiting their future research pathway and forcing women researchers to leave science at early stages of their career,” Dr Borger said.

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